Organs Of Donation

It was a Saturday, I remember that, though I couldn't say the month for sure. It was more than 40 years ago, but it still sticks in my mind.

An ambulance brought the boy and as they arrived that had no idea if he was dead or alive. I went out to examine him in the vehicle because if he was dead for sure then they'd go straight to the morgue, that's how it was done back then.

I recall thinking that he was oriental because his face was flat, then they told me he'd come off his motorbike and hit a lamp post head on.

He was barely breathing. We wheeled him in and passed a tube, get some oxygen into him but it didn't take long to realise we had a desperate case and he might not make it. We got skull X-rays and found his face was smashed in and part of it was stuffed back into his skull. There was a fracture running right across the base of the skull it it didn't take long to figure out that his brain was in bits. His brain stem was keeping him breathing but that was all there was.
About then his mother arrived, by some weird chance she'd been driving down the same road ten minutes behind his and recognised the smashed motorbike. Passersby told her where the ambulance was headed, so she turned up in A&E.

By the time she arrived we were sure it was hopeless and his pulse was fading.

Lets not bother with the gory details, suffice it to say that in half an hour we knew he was brain dead and she knew too. I took a deep breath and as carefully as I could I asked her if we could take his kidneys. She said yes immediately and asked if she could sit with him. I still don't know why I wasn't more upset, this was my second job as a doctor, I was about eight months out of medical school, really someone more senior should have been dealing with the whole thing, but it was a Saturday afternoon and back in those days there wasn't anyone else around.

I rang the transplant team who worked at another hospital across town and one of the surgeons turned up about fifteen minutes later.
I think by then we had managed to find someone who did an eeg and everything told the same story. If we stopped ventilating he didn't breath but pumping some oxygen in kept his heart beating.

We wheeled him across to the theatre and the surgeon removed the kidneys.

'What happens now?' I asked. 'Where do they go?'

'I don't know,' he said, 'we ask the typist.'

I remember another doctor behind me saying 'round here was ask the cleaners.'

Not much of a joke, but the sort of black humour that keeps us going on a bad afternoon. I think by then the stress was catching up with me a little. There was a small office just near reception - I retreated there to write up the notes.

I guess I was almost done and beginning to breath a bit more easily when the mother knocked on the door and stepped in.

'What about his eyes, can you take his eyes as well?'

'I think I managed to hold it together long enough to say yes and she left.

I phoned the eye guys and then I lost it. For ten minutes I say in the office with the lights out and wept. I wasn't just that I seen an eighteen year old killed when he should have been enjoying the weekend. It wasn't that I still owned a motorbike and could see myself doing the same thing. Those things I've come to terms with; what did it was that mother who clearly loved her son as much as any mother could, but somehow she managed to push that love on to others - to the two people who would have new kidneys by the end of the day and to the people who would be looking out at the world through her sons corneas.

I've always been a sucker for heroic deeds, but I don't think I've seen any better than that Saturday afternoon.